One Health: An integrated multidisciplinary approach to combat zoonoses
Pratik Ramesh Wankhade1* and Diksha Purushottam Gourkhede2
1Livestock Development Officer (Gr-A), Department of Animal Husbandry, Maharashtra State
2Assistant Professor, Department of Veterinary Public Health & Epidemiology, College of Veterinary and Animal Sciences, Kishanganj, Bihar
*corresponding author: pratikwr@gmail.com
Introduction
The one health concept has gained extraordinary importance over the past decade, which is not surprising given how closely intertwined and interdependent the boundaries between human, animal and environmental health. World Health Organization (WHO) has defined “One health” as an interdisciplinary approach for studying public health issues in humans, animals, and their surrounding environments. The one health is accomplished through a collaborative, multisectoral, coordinated and transdisciplinary actions. The concept of one health has emerged to address health issues at the human-animal-environment interface. The most common health related issues include emerging infectious diseases (viz., COVID 19, Avian influenza), zoonotic diseases, antimicrobial resistance and food safety. To deal with such issues, a basic prerequisite is the development of interdisciplinary team. The team consists of medical experts, veterinarians, ecologist, and person from public health administration. In case of zoonoses, the role of above mentioned experts is very important for immediate response and interventions to mitigate the public health threats.
A zoonoses is any disease or infection that is naturally transmissible from vertebrate animals to humans. Out of 1415 human pathogens, 868 pathogens are shared by animals, i.e., nearly 61% of human pathogens are zoonotic. If we consider the emerging diseases, nearly 73% of emerging diseases are zoonotic in origin. India is among the countries, which are having highest burden of zoonotic diseases. Considering the above facts, one health approach is gaining attention to combat the public health treats arising from emerging zoonotic diseases.
One health concept and its evolution
Centre for Disease Control (CDC) has given the definition of one health as “One Health an interdisciplinary, multi-sectoral & collaborative approach that can function at global, regional, national and local levels, with the objective of ensuring optimal health through the recognition of connections among environment, humans, animals and plants”. This approach helps in preventing health with integrated and multisectoral involvement at the interface of human, animal and environment. One health aimed to address the global need for clean water and air, safe food, safe environment for all.
In 19th century, the concept of one health came into existence when Rudolf Virchow (1821-1902) stated that “between human & veterinary medicine there is no dividing lines”. Over the centuries, this concept has emerged globally. In addition, the term “Eco Health” has also emerged with “One Health”. Eco health approach focuses above all on place of human beings within their environment and links between human being and their biophysical, social, and economic environments. This concept of one health and eco health has evolved in parallel over a period of time (Fig. 1: The parallel evolution of One health and Eco health).
In 2004, the wildlife conservation society formulated the One World-One Health concept. Subsequently, Food and Agriculture Organization (FAO), World Organization of Animal Health (OIE), United Nations Children’s Fund, World Bank and United Nations System Influenza Coordinator has released a document, entitled “Contributing to One World, One Health,” in 2008. Milestone in one health concept achieved when the global conference on One Health was held in May 2015 organized by World Veterinary Association (WVA) and World Medical Association (WMA) that helped in expanding the one health platform by recommending interdisciplinary collaboration to improve animal and human health. In India, the National Institute of One Health was established at Nagpur, Maharashtra in the year 2022. Globally, one health concept gaining more importance and several initiatives are taken to combat the various health related problems.
Why the One Health approach needed to prevent zoonoses?
Most of the human pathogens causes disease in animals and vice versa, as they share a common ecosystem. Also, the microorganisms get transmitted from animal to human directly and/or indirectly through shared environment. Out of 1415 human pathogens, 868 (61%) are zoonotic in nature and among the emerging pathogens 75% are zoonotic in origin. Globally, zoonotic diseases are responsible to cause nearly 2.5 billion human cases and about 2.7 million deaths per year. Zoonoses can cause a negative impact on human & animal health.
Zoonotic diseases have been their since long back in human history. A zoologist Kate Jones estimated that emerging diseases occur in 1940 and 2004 are dominated by zoonoses and majority of that were originated in wildlife. There are several factors that drive the emergence of zoonotic diseases such as anthropogenic changes in land use and agriculture, urbanisation, habitat destruction, increase demand for animal protein, use of bush meat and animal transport. As there are multiple factors involve in the emergence and transmission of zoonotic pathogens, so they cannot be prevented and eliminated by efforts of one sector alone. Therefore, to combat the health hazard cause by emerging zoonotic diseases, an interdisciplinary, multi-sectoral approach at human-animal-environment interface is needed. Moreover, one health approach provides unique opportunity to all the sectors to come together and work towards the sustainable development of country.
The one health approach helps in conducting nationwide diseases surveillance, prevention and control of zoonotic disease outbreaks to improve human and animal health. With the promotion of strong collaboration among different sectors, one health approach assists in strengthening disease surveillance, data sharing, diagnostics systems, and early response and detection of zoonotic pathogens. This collaborative approach can surely enhance the zoonotic disease prevalence and control and ensures the effective strategies towards reduction of zoonotic disease burden (Fig. 2: One health approach to combat zoonotic disease e.g. Brucellosis).
One Health action plans for prevention of zoonotic diseases
Globally, multiple initiatives have been developed to help countries by designing strategies, implementing programs, policy making, and implementing laws. The WHO, FAO, WOAH and United Nations Environmental Programme have collaboratively working to predict, detect, respond to global threats from emerging zoonotic diseases. The effective approaches to combat the hazard cause by zoonotic diseases are disease surveillance, increase the diagnostic facilities, emergency preparedness and response, developing taskforce and effective communication and sharing of information.
- Disease surveillance:Surveillance help in early detection of zoonotic diseases. Which helps in quick response and application of prevention and mitigation measures. Moreover, it supports in analysing the disease burden, monitoring its presence.
- Increase the diagnostic facilities:The laboratories for diagnosis of the zoonotic pathogens need to be established to fasten the process of early detection. The reference laboratories should share the data with the relevant sectors to improve reporting of the zoonotic disease outbreaks.
- Emergency preparedness and response: The persons from different sectors like human medicine, veterinarians and environmentalist must be trained and coordinated to respond towards a zoonotic disease outbreak. The facilities and resources from relevant sectors must be shared to control the outbreak.
- Developing taskforce:A workforce of human, animal health and environmental professionals at global, regional and national level need to be established. Countries need to be prepared to respond to any emerging zoonotic disease outbreaks. The taskforce must include physicians, veterinarians, laboratory technicians and epidemiologists, and policy makers.
- Data communication and information sharing:Communication strategies such as formal channels of communication, programs and messaging need to be incorporated to enable the sharing of resources. Also the risk communication should be proper to aware the public and to gain the maximum public support. Based on information collected from all the sources, data sharing need to be done across the relevant sectors for their timely collaboration.
Challenges in one health approach
The one health implementation has some challenges as it requires multi-sectoral collaboration. Differences in resource allocation among human, animal, and environmental health programs, as well as differences in education and training across disciplines and fields, are just a few of the obstacles that make one health approach difficult. In developing countries, weak coordination across human-animal-environmental health sectors persist which minimize the co benefits from all the sectors. Moreover, the very important challenge of one health approach includes increased human-animal interaction, increasing urbanization, changing ecosystem, close interaction between wildlife, livestock and human populations and diverse emerging and remerging zoonoses.
Conclusion
Emerging zoonotic diseases are becoming a global concern, as it has harmed public health and economy. In past two decades, several zoonotic disease outbreaks have been documented worldwide. With the increase in interconnection at the human-animal-environment interface, the threat of emergence of zoonotic pathogens is increasing. Thus, the multi-sectoral interdisciplinary action is required to effectively reduce down the burden of zoonotic diseases and to prevent the emergence of zoonotic pathogens. Moreover, there is necessity of working effectively towards promotion and implementation of one health approach.
